Artrosis y comorbilidad cardiovascular

Cristóbal Orellana, Joan Calvet
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Abstract

The relationship between osteoartritis (OA) and metabolic disorders, such as diabetes or dyslipemia, and cardiovascular comorbidity has been well established in epidemiologic studies, especially in the case of knee OA. This association has also been observed between OA and the metabolic syndrome, which is a major risk factor for cardiovascular disease. The functional disability resulting from advanced joint disease as well as Joint overload related to obesity and the the frequent coexistence of cardiovascular morbidity in an aging population were the major factors though to be involved. However, this ssociation has also been found in younger patients and in hand OA, thus pointing to the possible existence of additional factors not related to joint overload, diasbility or age. In recent years several metabolic and inflammatory factors present both in OA and in the different cardiovascular risk factors have been implicated, such as lipid homeostasis dysregulation and especially the activity of adipocytokines, cytokines released from adipose tissue with a synergistic action with proinflammatory cytokines and other inflammatory mediators. The evidence for this associations and the possible mechanisms are reviewed.

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骨关节炎和心血管共病
在流行病学研究中,骨关节炎(OA)与代谢紊乱(如糖尿病或血脂异常)以及心血管合并症之间的关系已经得到了很好的证实,尤其是在膝关节OA的情况下。OA与代谢综合征之间也存在这种关联,代谢综合征是心血管疾病的主要危险因素。晚期关节疾病导致的功能障碍、肥胖相关的关节负荷以及老年人群中心血管疾病的频繁共存是主要的影响因素。然而,在年轻患者和手部OA中也发现了这种关联,从而指出可能存在与关节超载、残疾或年龄无关的其他因素。近年来,一些代谢和炎症因素存在于OA和不同的心血管危险因素中,如脂质稳态失调,特别是脂肪细胞因子的活性,脂肪组织释放的细胞因子与促炎细胞因子和其他炎症介质协同作用。本文回顾了这种关联的证据和可能的机制。
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